It’s estimated that as many as 10 million women and 1 million men are battling with an eating disorder such as anorexia or bulimia, according to the National Eating Disorder Association. Millions more are struggling with binge eating or compulsive over-eating.

Prior to my work in Seattle, I worked as a counselor at a community college and also at an eating disorder clinic in Los Angeles where I saw clients grappling with issues related to food, eating, body-image, and self-esteem.

One client initially came into therapy not because of her bulimia but because of problems with her boyfriend. After numerous sessions she later revealed her need to occasionally vomit after eating. When I peeled back the layers of her life, I learned how much she yearned for her mother’s approval growing up. Her mother was critical, demeaning, and sent her the message that she was “not good enough”. She had been teased by her mother for her “baby fat” and was labeled as “ugly”. So in her desperate pursuit to gain approval from her family, she exercised religiously, ate small meals, and would occasionally purge. While she found some satisfaction in her slimmer figure, she constantly wrestled with doubt, fear, and insecurity. Unfortunately, what she longed for was unconditional love and acceptance from her family but instead settled for the cheap substitute of love.

Another client grew up in a divorced household where she lived with her father. Her father was consumed by work so she never had a real relationship with him. By high school, she stopped eating. Her anorexia got the attention of her father who tried to find treatment for her. But it became obvious that she did not want to give this up as the eating disorder brought her father into her life. The attention she so desperately wanted from her father only occurred when she struggled with anorexia and thus perpetuated the disorder.

Other clients struggle with eating due to issues of dependency. One adult client struggled with food because her parents still had a tight rein on her life decisions such as where she could live, work, or who she could date that she never learned to trust her own instincts or feelings. Because she hated this feeling of dependency, she rebelled by acting out through the only avenue where she had some semblance of control. But what she truly desired more than a decadent piece of chocolate or ice cream were understanding, connection, support, and validation which are things only another human can provide.

Others binge eat and use food as a form of comfort to numb out painful feelings such as anxiety, anger, loneliness, or depression. Food can also be used to cope with troubled relationships such as a break-up, loss, abuse, hurt or other past trauma. If someone has never learned how to express their feelings or deal with loss in a healthy way, then food can easily act as a way to stem the feelings from rising to the point of consciousness. But our emotions are strong and will seek a release unless we learn to process them and deal with them in our relationships. The only way people break free from these types of disorders is through positive, healthy relationships. Relationships heal.

From an Asian American perspective, we must help those struggling with eating disorders to not feel shamed since there’s such a stigma to anyone being less than perfect. We must help our culture acknowledge embrace our imperfections if we’re to deal effectively with those grappling with life’s challenges and looking for recovery.

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